Financial incentives may improve outcomes of dietary intervention among adolescents with severe obesity: JAMA
Researchers have found that combining financial incentives (FIs) with meal replacement therapy (MRT) significantly improves weight loss outcomes in adolescents with severe obesity. A recent study was published in the journal JAMA Pediatrics by Amy C. Gross and colleagues. This randomized clinical trial, conducted at a large academic health center in the Midwest from 2018 to 2022, aimed to evaluate the impact of FIs on BMI reduction, body fat, and cardiometabolic risk factors.
Adolescent severe obesity is notoriously difficult to treat with traditional lifestyle modification therapies. MRT has shown short-term efficacy for BMI reduction, but sustaining these outcomes over the long term remains challenging. Introducing FIs as an adjunct intervention could potentially enhance adherence to healthy behaviors and improve long-term efficacy.
The study involved 126 adolescents aged 13 to 17 years with severe obesity, defined as ≥120% of the 95th BMI percentile or a BMI ≥35. Participants were randomized to receive either MRT alone or MRT plus FIs. The MRT included preportioned, calorie-controlled meals (~1200 kcals/day). The FI group received incentives based on their weight reduction from baseline. The primary endpoint was the mean percentage change in BMI from randomization to 52 weeks. Secondary endpoints included changes in total body fat, blood pressure, triglyceride to high-density lipoprotein ratio, heart rate variability, and arterial stiffness. Cost-effectiveness and safety, particularly concerning unhealthy weight-control behaviors, were also assessed.
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